Synovial Fluid Analysis and The Evaluation of Patients With Arthritis

• Chapter 1. The impact of synovial fluid analysis on clinical practice – Introduction
• Chapter 2. Synovial structure and physiology in health and disease
• Chapter 3. Arthrocentesis
• Chapter 4. Biochemical Composition of Synovial Fluid in Health and Disease
• Chapter 5. Cellular Components of Synovial Fluid in Health and Disease
• Chapter 6. Microbiology and Culture Identification of Infections
• Chapter 7. Molecular Microbiology for Diagnosing Infectious Arthritis
• Chapter 8. Basics of Light Microscopic analysis of Synovial Fluid
• Chapter 9. Basics of Polarized light microscopy
• Chapter 10. Crystal associated arthritis: Gout
• Chapter 11. Crystal associated arthritis: Calcium pyrophosphate arthritis
• Chapter 12. Lipid crystals
• Chapter 13. Analytic methods to detect articular basic calcium phosphate crystals
• Chapter 14. Novel Techniques for Synovial Fluid Crystal Analysis
• Chapter 15. Atlas of Images--Normal and Abnormal Synovial Fluid

This book reviews the major components of synovial fluid analysis, with an emphasis on crystal recognition. Synovial fluid analysis is the required gold standard test for the definitive diagnosis of septic and crystal induced arthritis, the most frequent causes of acute inflammatory arthritis.

Synovial fluid is obtained routinely from patients with acute arthritis by clinicians in many specialties. Fluids are sent to the clinical pathology and microbiology laboratories for analysis, but are also frequently examined directly by rheumatologists and others for the presence of crystals. Competency in synovial fluid crystal analysis is a requirement for all graduating rheumatology fellows in the United States, and is an expectation for musculoskeletal disease physicians internationally – although competency is assumed with a variable degree of rigor. This book comprehensively provides practical knowledge presented by skilled and experienced clinicians and pathologists, fulfilling an educational niche for teaching programs and a reference need for academic and community hospital clinical pathology laboratories. This is an ideal introductory guide for rheumatology trainees, as well as a reference text for rheumatologists, infectious disease consultants, orthopedists, cytotechnologists, and advanced nurse practitioners.

Contributor Bio(s)

Brian Mandell is Professor and Chairman of Academic Medicine and a Senior Staff Physician in Rheumatology and Immunologic Diseases, Center for Vasculitis Care and Research at the Cleveland Clinic. He is Editor in Chief of the Cleveland Clinic Journal of Medicine. He is a Master of the American College of Physicians and the American College of Rheumatology.

Dr. Mandell joined the Cleveland Clinic in 1993 following a faculty appointment at the Hospital of the University of Pennsylvania and Chief of Rheumatology at the Graduate Hospital in Philadelphia, PA. He previously earned a BA in Biology and a PhD in Physiology and Biophysics from Washington University, St. Louis, and then a Medical Degree from New York University School of Medicine. He trained in medicine and rheumatology at the University of Pennsylvania. He is board certified in Internal Medicine and Rheumatology. He served as interim Director of Inflammation Research and Exploratory Clinical Pharmacology at CIBA Pharmaceuticals.

He is currently Editor-in-Chief of the Cleveland Clinic Journal of Medicine and is a Professor of Medicine at the Cleveland Clinic Lerner College of Medicine at Case Western Reserve University. He previously served as the Director of the Cleveland Clinic Internal Medicine Residency’s Scholarly Activity and Medical Humanities Programs. He is a graduate of the Stanford Faculty Development Program in clinical teaching. He completed a term as member of the Cleveland Clinic’s Board of Governors.

Dr. Mandell has served on national education planning and writing committees for the American College of Rheumatology (ACR), the American Board of Internal Medicine (ABIM) and the American College of Physicians (ACP), including serving as chairman of the Annual Meeting Planning Committee for both the ACP and ACR. He served as Vice Chairman of the ACGME Internal Medicine Residency Review Committee (RRC) until 2019. He has served on the Editorial Boards of several journals including Arthritis Care and Research, J Clin Rheumatology, and Arthritis and Rheumatology. He is an Editor of the Merck Manual (rheumatology and immunology sections). He has regularly presented the annual workshop on synovial fluid analysis at the annual ACR scientific meeting and speaks nationally and internationally on a range of topics including gout, synovial fluid analysis, vasculitis, medical education and medical authorship.

He has published approximately 200 articles, chapters, and editorials in peer-reviewed publications and textbooks related to clinical and basic aspects of medical science as well as medical education. He is a clinical investigator and has a special interest in gout as well as vasculitis and multi-system inflammatory diseases. He is on the board of directors of the Gout and Uric Acid Education Society.